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General NPI Number Information
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NPI Number | 1376743393
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Entity Type | Organization
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Legal Business Name | EASTWOOD CHIROPRACTIC OFFICE
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 206 N STATE ST
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City | GIRARD
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State | OH
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Zip | 44420-2536
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Country | US
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Telephone | 330-219-7312
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Fax | 330-288-4597
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Provider Business Mailing Address
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Address Line | 206 N STATE ST P.O.BOX 427
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City | GIRARD
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State | OH
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Zip | 44420-2536
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Country | US
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Telephone | 330-219-7312
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Fax | 330-288-4597
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. TERRENCE MATTHEW HALL
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Credential | DC
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Telephone | 330-219-7312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1078 OHIO
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License Number State | OH
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